摘要
目的探讨叶酸联合甲钴胺用于脑小血管病伴高同型半胱氨酸（Hcy）血症的临床效果。方法选择聊城市第二人民医院2015年1月至2016年12月诊治的脑小血管病伴高Hey血症患者78例为研究对象，且伴有血管性轻度认知功能障碍，采用随机数字表法分为两组，对照组39例，给予常规治疗，观察组39例，在对照组治疗基础上给予叶酸联合甲钴胺治疗。比较两组治疗前、治疗后Hcy、维生素B。叶酸水平和阿尔茨海默病评价量表．认知分量表（ADAS-cog）评分情况。结果治疗前，两组Hey水平差异无统计学意义（t=0．34，P=0．74）。对照组治疗后3、6个月血浆Hcy水平与治疗前差异均无统计学意义（t=0．36、1．30，均P〉0．05）；观察组治疗后3个月[（19．98±3．65）moL／L]、6个月[（．14．96±3．54）mol／L]Hcy水平较治疗前[（26．38±2．95）mol／L]均明显降低（t=8．52、15．48，均P〈0．05），且均明显低于对照组（t=7．11、12．35，均P〈0．05）。治疗前，两组维生素B12和叶酸水平差异均无统计学意义（t=0．27、0．86，均P〉0．05）；对照组治疗前后维生素B12和叶酸水平差异均无统计学意义（均P〉0．05）；观察组治疗后3、6个月维生素B12和叶酸水平较治疗前均明显升高（均P〈0．05），且均明显高于对照组（均P〈0．05）。治疗前，两组ADAS—cog量表评分差异无统计学意义（t=0．14，P〉0．05）；对照组治疗前后ADAS．cog量表评分差异无统计学意义（均P〉0．05）；观察组治疗后3个月[（12．05±2．13）分]、6个月[（10．24±2．84）分]ADAS-cog量表评分较治疗前[（15．07±3．56）分]明显降低（t=4．55、6．62，均P〈0．05），且较对照组亦显著降低（均P〈0．05）。结论脑小血管病伴有高Hcy血症患者应用叶酸和甲钴胺能够明显降低Hey水平，提高维生素B12及叶酸水平，有助于减轻其血管性认知功�
Objective To investigate the clinical effect of folic acid combined with methylcobalamin in the treatment of cerebral small vessel disease with hyperhomocysteinemia. Methods From January 2015 to December 2016,78 patients who were diagnosed cerebral small vessel disease with high homocysteinemia（Hcy） and also associ- ated with vascular mild cognitive impairment in the Second People＇s Hospital of Liaocheng were selected as the research objects, and they were randomly divided into control group and observation group, with 39 cases in each group. The control group was given routine treatment, and the observation group was treated with folic acid combined with mecobalamin on the bassis treatment of the control group. The levels of The Hcy, vitamin Bl2, folic acid and the Alzheimer~ disease assessment scale - cognihve subscale（ ADAS - cog） scores before and after treatment for 3 and 6 months were compared between the two gro.ups. Results Before treatment,there was no statistically significant differ- ence in the level of plasma Hey between the two groups （ t = 0.34, P = 0.74 ）. There was no statistically significant difference in the level of plasma Hcy of the control group between before and after 3 and 6 months treatment （t = 0. 36,1.30, all P 〉 0.05 ）. The plasma Hcy level in the observation group after 3 and 6 months treatment[ （ 19.98 ± 3.65 ） mol/L, （ 14.96 ± 3.54） mol/L] were significantly lower than that before treatment [ （26.38 ± 2.95 ） mol/L] （ t = 8.52,15.48, all P 〈 0.05 ） , which were also significantly lower than that in the control group （ t = 7.1 1, 12.35, all P 〈 0.05）. Before treatment, there were no statistically significant differences in vitamin B12 and folic acid levels between the two groups （ t = 0.27,0.86, all P 〉 0.05 ）. There was no statistically significant difference in the levels ofvitamin B12 and folic acid of the control group between before and after 3 and 6 months treatment（ all P 〉 O. 05 ）. The vitamin B12 and folic acid leve
作者
陈孝伟
Chen Xiaowei(Department of Neurology,the Second People＇s Hospital of Liaocheng,Liaocheng,Shandong 252000,Chin)
出处
《中国基层医药》
CAS
2018年第14期1866-1869,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
脑血管疾病
半胱氨酸血症
叶酸
甲钴胺
Basal ganglia cerebrovascular disease
Hyperhomocysteinemia
Folic acid
Mecobalamin
